Combined statement blank-check form and envelope



March 27, 1934. ,1 AI CQUNClLQR 1,952,972

COMBINED STATEMENT BLANK-CHECK FORM AND ENVELOPE Filed June 1, 193:5 2 sheets-sheet. 1

Mr John Do, |602.- J. ncr, Wash ingfon D. c.

M5 TRO/0L TA N @WLB/IVG WASHINGTON, 0. C.

| I I I I 5 7:4 TEMf/VT I l t 0A rf mena/LAR; afa/T mfp/7F 1MM/VCE J fvg III I J'Al//zcilor I l I l I I I I I March 27, 1934. J. A. couNclLoR 1,952,972

COMBINED STATEMENT BLANK-CHECK FORM AND ENVELOPE Fie June 1, 193s 2 sheets-sheet, 2

c Patented Mar. 27, 1934 4UNITED STATES CCDIBINED STATEMENT BLANK-CHEC FORM AND ENVELOPE James A. Councilor, Washington, D. C. Application June 1, 193?, SeriaLNo. 673,906

3 Claims.

` This `invention relates to a combined statement blank, check form and envelope, the object of which is to facilitate rendition of account statements, and lend encouragement to the payment 5 thereof. Such statements are particularly useful in connection with the commercial transactions of installment houses for the purposes of maintenance of account and the rendering of monthly statements showing either balances or installment amounts due. It is to be understood, however, that the invention is not; restricted to this field of use.

. To this end, the invention consists of a sheet or blank, including la sealing flap section, having printed thereon the necessary form serving the creditors purpose of statement of account and convenient check form by means of which the debtor may make payment by merely filling in the name of his bank, the amount, and his signature.

I-am aware that it has been proposed heretofore to combine statement and check blanks or forms, as such, but these are usually employed in commercial transactions by the debtor merely for the purpose of identification of the remittancecheck which is transmitted in payment of or on account rendered. The object of the present invention, however, is Widely different in that the blank and forms are so constructed and arranged as to advantageously serveboth the' creditor and debtor as a combined statement, remittance and mailing container.

By way of explanation, the statement may be prepared in full as to debit, credit and balance by the creditor and theblank so folded that the debtors name on said statement` serves as the mailing address when the statement is enclosed in a window envelope. The debtor upon receipt needs only 'illlbut the check form, refold the 40 blank as before except as to the sealing flap section which in this instance is simply reversed and sealed tothe outer face of a pre-folded section, thereby forming an envelope having suitably printed thereon the necessary return address data 454 and preferably prepaid postal or postal mailing permit.4 Since the debtor has at hand the check blank, the reply container, and prepaid postage,` prompt settlement of account is much encouraged and facilitated, and considerable expense on the Part of the creditor in the aggregate iseliminated as hereinafter set forth.

--Other objects and advantages of the invention will be hereinafter 'set forth and the novel features thereof dened by the appended claims.

In the drawings:

-ard ledger and le systems.

.carrying out the objects of the invention.

(Cl. 22S-92.7

Fig. 1 is a plan view of the blank forming the subject matter of this invention;

Fig. 2 is a View of the reverse side of said blank;

Figs. 3 to 6 lare detail views showing the steps of folding of the blank to its mailing condition;

Fig. 7 is a view showing in dotted lines the blank in a Window envelope ready for mailing to the debtor;

Fig. 8 is a view'of the blank as refolded for return by the addressee to the sender; i

Fig. 9 isa transverse section through the blank folded forl transmission to the addressee, and

Fig. 10 is a similar section in which the sealing flap is reversed for sealing the folded blank for return transmission.

Like referer .e characters designate corresponding paLts in the several figures of the drawings.

Referring to the drawings, the blank or sheet A is of any suitable size which lends itself best for the purposes of the invention, but preferably of such size as may be used conveniently in stand- The sheet may be retained in the individual files during the account period and from time to time the items may be entered thereon as the transactions occur. Book typewriting machines serve to best advantages in this adaptation, especially in view of the adaptability to duplication on the ledger sheets of wellknown type.

'Ihe sheet A is cut at one end to form the sealing flap B which has a mucilage edge C at its top extremity. On the face of the sheet side or longitudinal fold lines a, b-may be indicated in any v desired manner4 as by scoring, edge dots, or printed broken lines in the manner shown in the drawings. Likewise transverse fold lines c, d, e, are indicated. l

Essentially, so far as the forms go, the sheet is divided upon its face into three sections, namely, thev flap section at the top, the intermediate statement form section land the bottom check form section, but the transverse fold lines give the blank a four-section fold; which is important in Describing these sections more in detail, it will be noted in Fig. 1 that the ap section bears the name and address of the debtor so arranged as to be at the proper position to appear at the window :c of a window envelope y. As will be later shown, when the blank is returned in envelope form the addressee notation just referred to is hidden under the ilap. l

The statement section may contain `any desired data and form and I do not wish to be in 11()` however, at the top the creditor.s name and ad.- dress appears and beneath that av columnar arrangement for items, debits; credits, and balance 5 is printed.

Below said statement section is arranged the check form. The amount of the check, the name of debtors bank and signature are substantially all that is required to be lled in bythe debtor before the blank is in condition to be returned to the creditor. Preferably this check form has printed across the back of the section, as shown in Fig. 2, the necessary legend for a deposit endorsement by the creditor so as to render the c'heck non-negotiable in the event the blank should go astrayor be stolen.

Upon this reverse side of the return address of the sender together with the usual return postage permit stamp.

It will be apparent from the foregoing descrip- .tion that the debtor has a very convenient means n in hand to enable'settlement of account which is fully stated. Check and return postage being supplied itis a simple process to make the return. In order that it may be clear a description of the use of this invention will now be given. The

. creditor first applies' to the flap section the name and addressof the 4debtor and fills in the statement of account in the usual manner. The blank is now in condition to be folded and the rst step is shown in Fig. 3 wherein the side flaps are folded over. The next step involves the folding of the check section at the bottom upon the intermediate section as shown in Fig.' 4. Optionally, however, the check section may be folded first and -then the side flaps. -The third step is shown in Fig. 5 wherein another fold is made of the two sections above mentionedl uponfthe top section. This leaves the sealing flap section to be folded backwardly as shown in Fig. 6 exposing the name and address of the debtor and in this folded condition thev blank is slipped into a window envelope yas shown in Fig-7. The creditor now mails this enclosureto the debtor who upon receipt checks the correctness of the statement, lls in the blanks of the check and'refolds the blank in exactly the same manner as described exceptvingthat in this instance the sealing flap is folded in the reversedirection as shown in Figs. 8 and 10 to seal the blank in an envelope form.. The

blank, the upper sectionadjacent the flap has printed thereon the" said, to thereby form 1,952,972 any wise restricted as to this feature. Preferablyr mucilage edge is attached to the outer face of the intermediate section of the blank and not to the check section which, is of course folded within the other two sections. Since the address of the sender is alreadyprinted upon the outer face of the top section and prepaid postage arranged for,

the debtor simply has to drop the article into the lwithout departing from the spirit thereof as defined by the appended claims.

Having thus described my invention 'what I claim as new and desire to secure byv Letters Patent is:

1. A blank of the class described comprising a plurality of foldable sections including a check section and a sealing flap section adapted to bear upon its inner face thename and address of the addressee in position to be presented at the window of awindow envelope when the flap is turned backwardly against the adjacent folded section, one of said folded sections upon its reverse side' bearing the senders name and address for return purposes, said aptsection-Jhaving a mucilaged edge adapted to be sealed to the outer face of one of said foldable sections other than that bearing the senders name and address when the ap is reversed from the sending position aforea mailing envelope.

2. A combined statement check blank and envelope comprising upper, intermediate and check sections, and a flap section having a sealing edge,

said flap section when folded in one direction constituting .a' primary mailing direction and when folded in the reverse direction constituting means for sealing the blank in`envelope' form with the check securely enclosed therewithin.

3. Al blank ofthe class described comprising a and a check form section, said body portion having side flaps adapted in one direction to present mailing direction andl reversely foldable for [sealing against vthe statement section of the body portion when the latter isfolded iiito envelope form.

JAMES A. COUNCILOR.

when folded over the sections aforesaid to form an envelope, said body p ortion also having a sealing flap section foldable .body portion having a foldable statement section 

